Jeannie M Voegele, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

112-019 Issued in WI

Practice address

400 N Morris St
Stoughton, WI 53589-1857

Phone

(608) 873-5651

NPI assigned

May 25, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jeannie M Fogg III Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1487865713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 LEEWARD LN",
            "city": "OREGON",
            "state": "WI",
            "postal_code": "535753453",
            "telephone_number": "608-835-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MORRIS ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891857",
            "telephone_number": "608-873-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOEGELE",
        "first_name": "JEANNIE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "112-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40440400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNIE",
            "last_name": "FOGG",
            "middle_name": "M",
            "suffix": "III",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Stoughton, WI
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.